The Rochester Clinical and Translational Science Award (RCTSA) Program proposes continuation of its dual goals: 1) To organize, support, and expand clinical and translational research at the University of Rochester within an academic home, the University of Rochester Clinical and Translational Science Institute (URCTSI), and 2) To integrate and collaborate with regional and national institutions to expand a National Clinical and Translational Research Network. The RCTSA Program has truly transformed the University of Rochester Medical Center (URMC), with the construction of a state-of-the-art Clinical and Translational Science Building, the integration of clinical and translational science into the shared vision for URMC research, a successful system of dynamic governance, expansion of research resources, and enthusiastic participation and leadership in the National CTSA Consortium. To continue this momentum, the UR-CTSI will carry out a number of specific aims. First, three new key functions will be implemented: Public-Private Partnerships, T1 Translation, and Comparative Effectiveness Research. Existing Key Functions will be reorganized and consolidated to provide better support of investigators by an expanded Office of Regulatory Support, a Navigator/Consultation Service, and an Incubator Program consolidating Pilot Studies, Novel Methodologies, and Translational Technologies Key Functions. The CTSI will establish and foster four centers of research excellence across the spectrum of research translation: Center for Human Experimental Therapeutics (T1 Research); Clinical Research Center (T1-3 Research); Center for Research Implementation and Translation (T2-3 research under School of Nursing sponsorship); and Center for Community Health (T2-3 research). A broad range of education, training, and career development programs will continue to meet research workforce needs. The UR-CTSI will be an active participant in the National CTSA consortium with sharing of expertise, methods, data, and curricula. The Upstate New York Translational Research Network (UNYTRN) will be expanded to support the region's biomedical research institutions. Finally, the UR-CTSI will be evaluated through the measurement of rigorous performance outcomes.